Ano faktycznie, wystepuje takie zjawisko.


CRP Levels Increase After Statin Withdrawal


Charlene Laino


March 15, 2006 (Atlanta) — Withdrawing statin therapy results in a rapid and
significant increase in C-reactive protein (CRP) levels, researchers report.

"After three months, there is a reversal back to baseline levels," said
study coauthor Folkert Asselbergs, MD, PhD, from the University Medical
Center Groningen in the Netherlands. "Importantly, the increase in CRP is
independent of the parallel LDL [low-density lipoprotein cholesterol]
increase."

Previous research has shown that statin withdrawal leads to an increased
risk of cardiovascular disease due to a rapid rise in LDL cholesterol, but
the effect of withdrawal on CRP levels had not been well studied, Dr.
Asselbergs said.

To fill in the knowledge gap, his team evaluated the effects of withdrawal
from pravastatin, 40 mg, on CRP levels in 566 patients participating in the
randomized, placebo-controlled Prevention of Renal and Vascular End-stage
Disease Intervention Trial (PREVEND-IT) study.

Median CRP levels before randomization to study treatment were 1.3 mg/L for
both
groups. The median baseline LDL cholesterol level was 154 mg/dL for the 266
subjects in the placebo group and 159 mg/dL for the 300 patients in the
pravastatin group, an insignificant difference.

The findings were presented here at the 55th annual Scientific Session of
the American College of Cardiology (ACC).

At 4-year follow-up, CRP levels had increased by a nonsignificant 4.3% in
the placebo group (P = .40). In contrast, the levels decreased by 16% in the
pravastatin group (P = .002).

LDL cholesterol levels decreased by 27% in the pravastatin-treated patients
(P < 0.001) but were unchanged in the placebo group.

In addition, when participants in the pravastatin group stopped their
medication, both CRP and LDL levels increased to pretreatment levels. By 3
months, the median CRP level was 1.4 mg/L (P = .024) and the median LDL
cholesterol level was 153 mg/dL (P < .001).

After controlling for confounding factors, including age, sex, and smoking
status, the relative and absolute change of CRP level after discontinuing
pravastatin did not correlate with the change in LDL cholesterol level.

"The findings emphasize the importance of compliance," Dr. Asselbergs said.
"There is no sustained beneficial effect after therapy is stopped."

James H. Stein, MD, cochair of the meeting's program committee and associate
professor of medicine at the University of Wisconsin Medical School in
Madison, said the findings are a wake-up call to clinicians and patients
alike.

"I can't tell you how many patients say they feel better and want to stop
their medication," he told Medscape. "While it might seem like common sense
that the numbers will get worse, a study like this shows us the magnitude of
how bad things can really get."

ACC 55th Annual Scientific Sessions: Abstract 1003-185. Presented March 14,
2004.

Reviewed by Ariana Del Negro